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New Hampshire rates for HCPCS 96573

Photodynamic therapy by external application of light to destroy premalignant lesions of the skin and adjacent mucosa with application and illumination/activation of photosensitizing drug(s) provided by a physician or other qualified health care professional, per day

Insurance Carrier
Aetna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$173.78 / $234.42 / $562.34
Anthem BCBS
Facility/Professional
Professional
Modifier
Low / Median / High Price
$218.78 / $416.87 / $602.56
Cigna
Facility/Professional
Professional
Modifier
Low / Median / High Price
$199.53 / $309.03 / $660.69
Harvard Pilgrim
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,413.10 / $7,413.10 / $7,413.10
Harvard Pilgrim
Facility/Professional
Professional
Modifier
Low / Median / High Price
$257.04 / $426.58 / $676.08
United
Facility/Professional
Facility
Modifier
Low / Median / High Price
$7,413.10 / $7,413.10 / $7,413.10
United
Facility/Professional
Professional
Modifier
Low / Median / High Price
$239.88 / $346.74 / $741.31
Well Sense
Facility/Professional
Facility
Modifier
Low / Median / High Price
$251.19 / $251.19 / $309.03